Vascular cognitive impairment (VCI) refers to a clinical syndrome primarily characterized by cognitive dysfunction caused by damage to brain tissue due to cerebrovascular disease. Its etiology is complex and diverse, encompassing underlying diseases, genetics, immunology, environmental factors, and other aspects. Most cases of VCI exhibit a chronic, insidious, and progressive onset, involving multiple clinical stages. Currently, modern medicine primarily focuses on treating individual etiologies, with considerable research on stroke prevention and treatment. Clinically, it is advisable to follow modern medical methods, control controllable risk factors, and intervene and treat early to achieve better primary or secondary prevention effects and delay disease progression. Regarding the cognitive impairment associated with VCI, modern medicine has not yet discovered effective therapeutic drugs. However, ancient Chinese medical texts contain treatment plans for corresponding conditions. Therefore, combining basic western medical treatment with traditional Chinese medicine (TCM) for the prevention and treatment of this disease has become a current research hotspot. This paper aims to explore the advancements in the prevention of VCI by collating preventive measures for VCI in ancient Chinese medical literature and combining them with modern medical methods, providing a reference for clinical practice.